Provider Demographics
NPI:1396002176
Name:NICKELBERRY-ALEXANDER, QUIANA SADE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:QUIANA
Middle Name:SADE
Last Name:NICKELBERRY-ALEXANDER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9562 RAINTREE LN
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-3184
Mailing Address - Country:US
Mailing Address - Phone:504-223-4848
Mailing Address - Fax:
Practice Address - Street 1:1 GALLERIA BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2082
Practice Address - Country:US
Practice Address - Phone:504-223-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA243191363LF0000X, 363LF0000X
LARN125095376K00000X, 163WH0200X, 376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant